=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063700870
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUALITY MEDICAL SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2011
-----------------------------------------------------
Last Update Date | 01/21/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 332 E RIDGEWAY AVE
-----------------------------------------------------
City | WATERLOO
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50702-5042
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-232-1588
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 332 E RIDGEWAY AVE
-----------------------------------------------------
City | WATERLOO
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50702-5042
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-232-1588
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. STEPEHEN P GRIGGS
-----------------------------------------------------
Credential | CEO
-----------------------------------------------------
Telephone | 407-206-0040
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 6264
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------